Individual
MRS. BROOKE BUCKENTINE SIMONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
424 W STATE HIGHWAY 5, WACONIA, MN 55387-1795
(952) 442-4461
(952) 442-1547
Mailing address
424 W STATE HIGHWAY 5, WACONIA, MN 55387-1795
(952) 442-4461
(952) 442-1547
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11322
MN
Other
Enumeration date
08/02/2011
Last updated
06/30/2026
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